STEMI合并多支血管病变患者首次住院期间完全血运重建对预后的影响

Influence of complete revascularization on prognosis in patients with ST-segment elevation myocardial infarction complicated by multi-vessel lesions during first hospitalization period

目的探讨ST段抬高型心肌梗死(STEMI)合并多支血管病变患者首次住院期间完全血运重建对预后的影响。方法选取2018年2月至2019年2月于安徽医科大学阜阳临床学院心血管内科住院治疗的164例STEMI合并多支血管病变(MVD)患者,采用随机数字表法将其分为观察组和对照组。观察组84例,于首次住院期间完全血运重建;对照组80例,出院后2月内完全血运重建。比较两组患者发病后1年内发生主要不良心血管事件(MACE)的差异有无统计学意义。结果两组发病后1年内MACE发生率差异无统计学意义(21.0%vs.19.0%,P=0.669),但观察组造影剂总量[220.0(150.0,250.0)ml vs.285.0(250.0,322.5)ml,P=0.000]、植入支架总个数[2.0(2.0,3.0)枚vs.3.0(2.3,3.8)枚,P=0.000]、植入支架平均直径[3.1(3.0,3.5)mm vs.3.0(2.8,3.2)mm,P=0.013]、植入支架总长度[57.0(50.0,71.0)mm vs.82.0(57.0,107.0)mm,P=0.000]、住院总时间[12.0(11.0,14.0)天vs.19.5(16.3,21.8)天,P=0.000]、总费用[51372.0(44136.0,58446.0)元vs.67874.0(64942.0,74704.0)元,P=0.000]均低于对照组,差异有统计学意义。结论STEMI合并MVD患者首次住院期间完全血运重建安全可行且能够减少住院时间和费用。

Objective To investigate the influence of complete revascularization on prognosis in patients with ST-segment elevation myocardial infarction(STEMI)complicated by multi-vessel lesions(MVD)during first hospitalization period.Methods STEMI patients complicated by MVD(n=164)were chosen from Department of Cardiovascular Medicine in Fuyang School of Clinical Medicine of Anhui Medical University from Feb.2018 to Feb.2019,and divided into observation group and control group by applying random digital table.The observation group(n=84)were given complete revascularization during first hospitalization period,and control group(n=80)were given complete revascularization within 2 months after discharged from hospital.The difference in major adverse cardiovascular events(MACE)was compared between 2 groups within 1 y after the disease onset.Results The difference in incidence rate of MACE had no statistical significance between 2 groups(21.0%vs.19.0%,P=0.669)within 1 y after the disease onset.The total amounts of contrast[220.0(150.0,250.0)ml vs.285.0(250.0,322.5)ml,P=0.000],the total number of stents[2.0(2.0,3.0)vs.3.0(2.3,3.8),P=0.000],mean diameter of stent[3.1(3.0,3.5)mm vs.3.0(2.8,3.2)mm,P=0.013],the total length of stent[57.0(50.0,71.0)mm vs.82.0(57.0,107.0)mm,P=0.000],the total length of hospital stay[12.0(11.0,14.0)vs.19.5(16.3,21.8),P=0.000]and the total cost[51372.0(44136.0,58446.0)yuan vs.67874.0(64942.0,74704.0)yuan,P=0.000]were all lower in observation group than those in control group,and the difference had statistical significance.Conclusion The complete revascularization is safe and feasible in patients with STEMI complicated by MVD during first hospitalization period,and hospital stay time and cost can be reduced.